What Can the United States Learn from Taiwan?

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<p>In its pursuit of meaningful health care reform, the United States can learn a lot from the experiences of other industrialized countries. A new commentary from Commonwealth Fund president Karen Davis, Ph.D., and Duke University Medical Center's Andrew T. Huang, M.D., takes a look at Taiwan's recent move to universal health insurance coverage and the lessons it holds for the U.S.</p><p>In <a href="/publications/in-the-literature/2008/feb/learning-from-taiwan--experience-with-universal-health-insurance
">"Learning from Taiwan: Experience with Universal Health Insurance,"</a> (<em>Annals of Internal Medicine,</em> Feb. 19, 2008) Davis and Huang focus on a new study of life expectancy before and after Taiwan's introduction of national health insurance in 1995, which increased coverage from 57 percent to 98 percent of the population. Taiwan has seen a modest rise in overall life expectancy following enactment, and those living in areas with the worst health have experienced significant improvements.</p><p>Health spending in Taiwan, meanwhile, has remained unchanged at 5 to 6 percent of GDP. Still, there are concerns over the plan's long-term financial sustainability. Also troubling is Taiwan's system of physician payment incentives, which can have an adverse effect on how medical trainees choose their specialties.</p><p>Taiwan's successes and challenges underscore the importance of a health reform strategy that simultaneously addresses issues of access, quality, and efficiency--the underpinnings of any high performing health system.